Enhancing kidneys and contrast excretion due to previous PCI on non-enhanced CT scan.
On ECG-gated CTA, no aortic dissection is present. Generalised severe atherosclerosis is evident:
severe stenosis on both subclavian arteries and brachiocephalic trunk
chronic occlusion at the aortic bifurcation (Leryche -syndrome)
chronic occlusion of superior mesenteric artery
LAD proximal segment occlusion and signs of severe acute heart failure:
LAD proximal segment occlusion
distal enhancement may be due to collaterals
hypodense myocardium (on venous phase) at LAD territory, suggesting myocardial ischaemia
huge amount of intravenous contrast regurgitation into the inferior caval vein.
bilateral alveolar lung oedema
regular pulmonary spetal thickening
Signs of aspiration:
intubated
bilateral dorsal/basal consolidations